Skip to main content
SpringerLink
Log in
Book cover

Advances in Radiation Oncology in Lung Cancer pp 513–520Cite as

Prophylactic Cranial Irradiation in Small-Cell Lung Cancer

  • Chapter
  • First Online:

  • 1748 Accesses

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

Abstract

Prophylactic cranial radiation (PCI) has been used in the management of small-cell lung cancer given the propensity of disease relapse in the brain. Several studies have shown that PCI reduces the rate of brain metastases and improves survival. However, the use of PCI in the management of small-cell lung cancer has been controversial due to conflicting evidence of efficacy and toxicities. For example, the most effective radiation dose and fractionation regimen is not known. Also, conflicting reports on the neurotoxicity of PCI make it difficult to make definitive conclusions regarding the side-effects of treatment. As the survival of patients with SCLC improves, the controversies regarding the neurotoxic effect of PCI may become more defined. Certainly, well-designed prospective clinical trials addressing these issues are needed and are ongoing.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   279.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Abbreviations

Gy:

Gray

Fx:

Fractions

BID:

Twice-daily

LS:

Limited stage

ES:

Extensive stage

SCLC:

Small-cell lung cancer

NSCLC:

Non-small-cell lung cancer

References

  • Abayomi OK (1996) Pathogenesis of irradiation-induced cognitive dysfunction. Acta Oncol 35(6):659–663

    Article  PubMed  CAS  Google Scholar 

  • Arriagada R, Le Chevalier T et al (1995) Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. J Natl Cancer Inst 87(3):183–190

    Article  PubMed  CAS  Google Scholar 

  • Aupérin A, Arriagada R et al (1999) Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. N Engl J Med 341(7):476–484

    Article  PubMed  Google Scholar 

  • Bremnes RM, Sundstrom S et al (2001) Multicenter phase II trial of paclitaxel, cisplatin, and etoposide with concurrent radiation for limited-stage small-cell lung cancer. J Clin Oncol 19(15):3532–3538

    PubMed  CAS  Google Scholar 

  • Broadbent NJ, Squire LR et al (2004) Spatial memory, recognition memory, and the hippocampus. Proc Natl Acad Sci USA 101(40):14515–14520

    Article  PubMed  CAS  Google Scholar 

  • Cox JD, Petrovich Z et al (1978) Prophylactic cranial irradiation in patients with inoperable carcinoma of the lung: preliminary report of a cooperative trial. Cancer 42(3):1135–1140

    Article  PubMed  CAS  Google Scholar 

  • Giuliani M, Sun A et al (2010) Utilization of prophylactic cranial irradiation in patients with limited stage small cell lung carcinoma. Cancer 116(24):5694–5699

    Article  PubMed  Google Scholar 

  • Gondi V, Tolakanahalli R et al (2010) Hippocampal-sparing whole-brain radiotherapy: a “how-to” technique using helical tomotherapy and linear accelerator-based intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys 78(4):1244–1252

    Article  PubMed  Google Scholar 

  • Gore EM, Bae K et al (2011) Phase III comparison of prophylactic cranial irradiation versus observation in patients with locally advanced non–small-cell lung cancer: primary analysis of radiation therapy oncology group study rtog 0214. J Clin Oncol 29(3):272–278

    Article  PubMed  Google Scholar 

  • Gregor A, Cull A et al (1997) Prophylactic cranial irradiation is indicated following complete response to induction therapy in small cell lung cancer: results of a multicentre randomised trial. Eur J Cancer 33(11):1752–1758

    Article  PubMed  CAS  Google Scholar 

  • Grosshans DR, Meyers CA et al (2008) Neurocognitive function in patients with small cell lung cancer. Cancer 112(3):589–595

    Article  PubMed  Google Scholar 

  • Gutierrez AN, Westerly DC et al (2007) Whole brain radiotherapy with hippocampal avoidance and simultaneously integrated brain metastases boost: a planning study. Int J Radiat Oncol Biol Phys 69(2):589–597

    Article  PubMed  Google Scholar 

  • Hansen HH (1973) Should initial treatment of small cell carcinoma include systemic chemotherapy and brain irradiation? Cancer Chemother Rep 3, 4(2):239–241

    Google Scholar 

  • Hsu F, Carolan H et al (2010) Whole brain radiotherapy with hippocampal avoidance and simultaneous integrated boost for 1–3 brain metastases: a feasibility study using volumetric modulated arc therapy. Int J Radiat Oncol Biol Phys 76(5):1480–1485

    Article  PubMed  Google Scholar 

  • Jackson DV Jr, Richards F 2nd et al (1977) Prophylactic cranial irradiation in small cell carcinoma of the lung. a randomized study. JAMA 237(25):2730–2733

    Article  PubMed  Google Scholar 

  • Jeremic B, Shibamoto Y et al (1999) Role of radiation therapy in the combined-modality treatment of patients with extensive disease small-cell lung cancer: a randomized study. J Clin Oncol 17(7):2092

    PubMed  CAS  Google Scholar 

  • Komaki R, Cox JD et al (1981) Risk of brain metastasis from small cell carcinoma of the lung related to length of survival and prophylactic irradiation. Cancer Treat Rep 65(9–10):811–814

    PubMed  CAS  Google Scholar 

  • Komaki R, Meyers CA et al (1995) Evaluation of cognitive function in patients with limited small cell lung cancer prior to and shortly following prophylactic cranial irradiation. Int J Radiat Oncol Biol Phys 33(1):179–182

    Article  PubMed  CAS  Google Scholar 

  • Laplanche A, Monnet I et al (1998) Controlled clinical trial of prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. Lung Cancer 21(3):193–201

    Article  PubMed  CAS  Google Scholar 

  • Le Pechoux C, Dunant A et al (2009) Standard-dose versus higher-dose prophylactic cranial irradiation (PCI) in patients with limited-stage small-cell lung cancer in complete remission after chemotherapy and thoracic radiotherapy (PCI 99–01, EORTC 22003–08004, RTOG 0212, and IFCT 99–01): a randomised clinical trial. Lancet Oncol 10(5):467–474

    Article  PubMed  Google Scholar 

  • Lee JS, Umsawasdi T et al (1987) Timing of elective brain irradiation: a critical factor for brain metastasis-free survival in small cell lung cancer. Int J Radiat Oncol Biol Phys 13(5):697–704

    Article  PubMed  CAS  Google Scholar 

  • Lee JJ, Bekele BN et al (2006) Decision analysis for prophylactic cranial irradiation for patients with small-cell lung cancer. J Clin Oncol 24(22):3597–3603

    Article  PubMed  Google Scholar 

  • Levitan N, Dowlati A et al (2000) Multi-institutional phase I/II trial of paclitaxel, cisplatin, and etoposide with concurrent radiation for limited-stage small-cell lung carcinoma. J Clin Oncol 18(5):1102–1109

    PubMed  CAS  Google Scholar 

  • Meert AP, Paesmans M et al (2001) Prophylactic cranial irradiation in small cell lung cancer: a systematic review of the literature with meta-analysis. BMC Cancer 1:5

    Article  PubMed  CAS  Google Scholar 

  • Monje ML, Mizumatsu S et al (2002) Irradiation induces neural precursor-cell dysfunction. Nat Med 8(9):955–962

    Article  PubMed  CAS  Google Scholar 

  • Nugent JL, Bunn PA Jr et al (1979) CNS metastases in small cell bronchogenic carcinoma: increasing frequency and changing pattern with lengthening survival. Cancer 44(5):1885–1893

    Article  PubMed  CAS  Google Scholar 

  • Ohonoshi T, Ueoka H et al (1993) Comparative study of prophylactic cranial irradiation in patients with small cell lung cancer achieving a complete response: a long-term follow-up result. Lung Cancer 10(1–2):47–54

    Article  PubMed  CAS  Google Scholar 

  • Shaw E, Su J et al (1994) Prophylactic cranial irradiation in complete responders with small-cell lung cancer: analysis of the mayo clinic and north central cancer treatment group data bases. J Clin Oncol 12(11):2327–2332

    PubMed  CAS  Google Scholar 

  • Slotman B, Faivre-Finn C et al (2007) Prophylactic cranial irradiation in extensive small-cell lung cancer. N Engl J Med 357(7):664–672

    Article  PubMed  CAS  Google Scholar 

  • Slotman BJ, Mauer ME et al (2009) Prophylactic cranial irradiation in extensive disease small-cell lung cancer: short-term health-related quality of life and patient reported symptoms—results of an international phase III randomized controlled trial by the eortc radiation oncology and lung cancer groups. J Clin Oncol 27(1):78–84

    Article  PubMed  Google Scholar 

  • Sun A, Bae K et al (2011) Phase III trial of prophylactic cranial irradiation compared with observation in patients with locally advanced non–small-cell lung cancer: neurocognitive and quality-of-life analysis. J Clin Oncol 29(3):279–286

    Article  PubMed  Google Scholar 

  • Suwinski MD, PDR, MSSP, Lee MD et al (1998) Dose–response relationship for prophylactic cranial irradiation in small cell lung cancer. Int J Radiat Oncol. Biol Phys 40(4):797–806

    Google Scholar 

  • Tai P, Tonita J et al (2003) Twenty-year follow-up study of long-term survival of limited-stage small-cell lung cancer and overview of prognostic and treatment factors. Int J Radiat Oncol Biol Phys 56(3):626–633

    Article  PubMed  Google Scholar 

  • Turrisi AT, Kim K et al (1999) Twice-daily compared with once-daily thoracic radiotherapy in limited small-cell lung cancer treated concurrently with cisplatin and etoposide. N Engl J Med 340(4):265–271

    Article  PubMed  CAS  Google Scholar 

  • Wolfson AH, Bains Y et al (2001) Twice-daily prophylactic cranial irradiation for patients with limited disease small-cell lung cancer with complete response to chemotherapy and consolidative radiotherapy: report of a single institutional phase II trial. Am J Clin Oncol 24(3):290–295

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Radiation Oncology, Mayo Clinic College of Medicine, Charlton Building, 200 First Street SW, Rochester, MN, 55905, USA

    Michael C. Stauder & Yolanda I. Garces

Authors
  1. Michael C. Stauder
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yolanda I. Garces
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yolanda I. Garces .

Editor information

Editors and Affiliations

  1. Institute of Lung Diseases, Institutski put 4, Sremska Kamenica, 21204, Serbia

    Branislav Jeremic

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Stauder, M.C., Garces, Y.I. (2011). Prophylactic Cranial Irradiation in Small-Cell Lung Cancer. In: Jeremic, B. (eds) Advances in Radiation Oncology in Lung Cancer. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2011_270

Download citation

  • DOI: https://doi.org/10.1007/174_2011_270

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-19924-0

  • Online ISBN: 978-3-642-19925-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation